Individual provider · Type 1 NPI
Derek Booth
Psychiatric/Mental Health Nurse Practitioner · Lafayette, IN
NPI number
1568852986
Active
Practice location
415 N 26th St, Suite 201
Lafayette, IN 47904-2895
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 71005314B (IN) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1568852986
Derek Booth's National Provider Identifier is 1568852986, issued on Jan 24, 2015. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Lafayette, IN. The record was last updated on Jan 24, 2015.